Pretty (Courageous) in Pink: Color These Cancer Warriors Optimistic

If there’s one message Elaine Grobman has for Philadelphia, it’s this: There just isn’t enough pink.

It’s because there’s too much breast cancer,” says the CEO of Susan G. Komen Philadelphia. “You have people’s lives at stake, and if pink gets your attention and makes you think about taking care of yourself, what could be bad about it?”

Susan G. Komen Philadelphia was established in 2001, and this year alone the local affiliate of the national organization distributed 31 grants worth millions. There are Komen dollars in every great research advancement in breast cancer, Grobman says, and the progress over the years has been significant.

“Women are living longer as a result of those advancements, but even so, we are an army battling a disease that’s taking the lives of our mothers, daughters and grandmothers. We need to keep fighting, because we are not done.”

There are more than 100 Komen affiliates in the United States, but the Philadelphia affiliate of Susan G. Komen has proved itself a leader. Breast health programs in Philly and 15 surrounding counties in Pennsylvania, New Jersey and Delaware receive an average of $2.3 million each year in grants that go to some 31 organizations.

For the 2013-2014 year, these funds will finance 4,399 screening mammograms, 1,949 diagnostic services, 3,295 clinical breast exams and treatment assistance for 347 breast cancer patients, as well as education, outreach and referrals.

One of the grant recipients is Dr. Ari Brooks, professor of surgery at Drexel University College of Medicine. Brooks met Grobman 12 years ago, when he wrote a grant application that would fund the treatment of uninsured women with breast cancer. He received the funding that year, and for the next decade, too — a total of approximately $1.3 million.

“Pennsylvania has a HealthyWoman Program that allows us to do screening mammograms for uninsured women, and if they’re diagnosed with cancer, get them insured with the state Medicaid program,” he explains.

“But the question is how to get women screened — how do they even find out about the screening program? And not every woman is eligible for the HealthyWoman Program. Komen Philadelphia has helped us screen 7,000 women who needed help, and allowed us to identify over 200 cancers. The Komen grant fills the gap that the state program doesn’t cover.”

The survival for breast cancer has been improving significantly, says Dr. Richard Bleicher, co-leader of the breast service line at Fox Chase Cancer Center in Philadelphia. “We’ve had major advances in breast cancer research and we can’t accomplish those advances unless we have research funding.”

Medications like Trastaumab have completely changed the outcome of HER2 breast cancer, for example. “HER2 positive disease has a poor prognosis, but this drug has markedly improved the chance of recurrence and survival for those patients,” he says.

In terms of medical imaging, the three-dimensional mammograms available today deliver a clearer picture of breast tissue and decrease the number of times women have to be called back for follow-up mammograms. For women who require it, breast reconstruction has become less invasive and more skin sparing than ever before as a result of more research.

“There have unquestionably been radical changes in how we treat breast cancer over the past 30 years,” Bleicher reflects. “For example, it’s very survivable today as a result of changes in treatment. The money and research that’s gone to breast cancer has definitely made a difference in survival and outcomes, options for women, complications and side effects.”

Dr. Kevin Fox, a medical oncologist and medical director of the Rena Rowan Breast Center at Penn’s Abramson Cancer Center, says that “the landscape of research funding has changed and will continue to change indefinitely. Our collective reliance on funding from nongovernment, nonindustry sources is greater than ever. The Komen Foundation has been a benchmark organization, and continues to set the standard for philanthropic organizations everywhere.

“The organization’s commitment to raising funds for clinical research and to enhance patient awareness has been remarkable, noble, and, thankfully, unrelenting. I don’t know where we would be without them.”

The kind of research that has made these advancements possible would not have happened without private funding of the kind that Susan G. Komen makes available. “When it comes to breast cancer, Komen is the most visible organization and everyone knows what the pink ribbon is,” he says.

“When patients come in today, they ask incredibly insightful questions because of the work the Komen Foundation has done. The ubiquity of the pink ribbon allows patients to come in asking those intelligent questions.”

Komen has funded eight research grants at the Fox Chase Cancer Center.

The advancements in breast cancer in the United States are particularly striking when compared with the severity of breast cancers diagnosed in other countries, Bleicher says. “We tend to diagnose earlier in the U.S. than in other countries because of all the information that’s out there,” he explains.

“Sure, we still have to treat advanced cancers here, but in the future, I believe we’ll be diagnosing things almost at a genomic level, based on predictions of who is at the highest risk of breast cancer and how to prevent it before they even get it.”

The heightened awareness of breast cancer as a result of the conspicuous pink ribbon campaigns and the work of Susan G. Komen nationwide has had far-reaching effects. At Jay Ann Intimates, a lingerie store that does mastectomy and lumpectomy fittings for women who have had breast cancer, women are more aware of the breast cancer products available, says Farrell Friedenberg, the proprietor.

She uses the pink ribbon because it’s “the universal symbol of breast cancer — it lets women know I’m not just a lingerie shop,” she says.

Half the revenue generated by Jay Ann Intimates, which has locations in Huntington Valley and at the Fox Chase Cancer Center, is from these fittings, and the number of fittings done at the store has grown significantly in the last decade.

“We’re seeing customers whose breast cancer has been detected at an earlier stage because it’s not this hidden disease anymore,” Friedenberg says.

More women are opting for breast reconstruction today than did so a few years back, she adds, but for those who don’t, the array of prostheses is incredibly diverse. “The prostheses are lighter weight now, in all different shapes. Some are hollow, like a yarmulke, for women who need a little shape. We also stock pajamas and lounge wear with pockets now, for prostheses.”

Thirty years ago there was a definite sense of shame associated with breast cancer, and that’s changed today as a result of education, outreach and research, says Lisa Wollan, president of the board of the Philadelphia affiliate of Susan G. Komen.

“That sense of shame led to not being able to acknowledge there was a problem, which led to not going to the doctor until it was too late, which meant remedies for breast cancer were somewhat limited.

“Because of the millions of dollars Komen has invested, the landscape has changed,” she reflects. “There are promising studies right now, primarily being led by Komen, that are looking for a cure for breast cancer. Our goal is that in 30 years’ time, we don’t have the same issues we have today.”

South African native Lauren Kramer is an award-winning writer based in Western Canada. This article first appeared in the special section of "Fighting Cancer."